Add wos sample results library
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abstract: 'Lay Summary Ask-Advise-Connect (AAC) simplifies and streamlines the
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process of asking patients about their smoking status, advising smokers
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to quit, and connecting patients through the electronic health record
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with free, evidence-based tobacco cessation treatment offered by state
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Quitlines. This study is the first to evaluate perceptions of AAC among
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clinic leadership and staff. After an 18-month implementation of AAC at
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a clinic serving mostly low-income Latinos and Latinas, clinic staff
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(e.g., medical assistants) and leaders were interviewed. Respondents
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reported that AAC streamlined their efforts to get patients to quit
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smoking, was easy to carry out, and fit well into the clinic flow. Staff
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wanted to keep AAC as the standard of care and made suggestions to
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improve how AAC works. They reported positive feedback from patients. In
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addition, a similar proportion of smokers enrolled in Quitline treatment
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as in other AAC trials. Thus, AAC worked well for patients and clinic
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staff. Having AAC in other clinics could improve enrollment in
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evidence-based smoking cessation treatment, facilitate successful
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smoking cessation among low-income primary care patients, and reduce
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burden on healthcare providers.
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This study is the first to evaluate clinic staff and leadership
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perceptions of Ask-Advise-Connect (AAC), which seamlessly connects
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smokers in healthcare settings with evidence-based tobacco treatment
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using the EHR. Clinic staff and leadership reported enthusiasm for AAC
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implementation, as the procedure streamlined the clinic''s smoking
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cessation efforts, fit well into clinic flow, and was beneficial to
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patients.
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Ask-Advise-Connect (AAC) efficiently links smokers in healthcare
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settings with evidence-based Quitline-delivered tobacco treatment
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through training clinic staff to systematically ask patients about
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smoking status, advise smokers to quit, and connect patients with state
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Quitlines using the electronic health record. This study utilized a
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mixed-methods approach, guided by the RE-AIM framework, to evaluate the
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implementation of AAC in a Federally Qualified Health Center (FQHC). AAC
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was implemented for 18 months at a FQHC serving primarily
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low-socioeconomic status (SES) Latinos and Latinas. Results are
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presented within the RE-AIM conceptual framework which includes
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dimensions of reach, effectiveness, adoption, implementation, and
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maintenance. Quantitative patient-level outcomes of reach,
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effectiveness, and Impact were calculated. Post-implementation, in-depth
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interviews were conducted with clinic leadership and staff (N = 9) to
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gather perceptions and inform future implementation efforts. During the
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implementation period, 12.0\% of GNHC patients who reported current
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smoking both agreed to have their information sent to the Quitline and
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were successfully contacted by the Quitline (Reach), 94.8\% of patients
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who spoke with the Quitline enrolled in treatment (Effectiveness), and
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11.4\% of all identified smokers enrolled in Quitline treatment
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(Impact). In post-implementation interviews assessing RE-AIM dimensions,
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clinic staff and leadership identified facilitators and advantages of
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AAC and reported that AAC was easy to learn and implement, streamlined
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existing procedures, and had a positive impact on patients. Staff and
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leadership reported enthusiasm about AAC implementation and believed AAC
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fit well in the clinic. Staff were interested in AAC becoming the
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standard of care and made suggestions for future implementation. Clinic
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staff at a FQHC serving primarily low-SES Latinos and Latinas viewed the
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ACC implementation process positively. Findings have implications for
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streamlining clinical smoking cessation procedures and the potential to
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reduce tobacco-related disparities.'
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affiliation: 'Fennell, BS (Corresponding Author), H Lee Moffitt Canc Ctr \& Res Inst,
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Dept Hlth Outcomes \& Behav, Tampa, FL 33612 USA.
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Shorey Fennell, Bethany; Cottrell-Daniels, Cherell; Vidrine, Damon J.; Vidrine,
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Jennifer, I, H Lee Moffitt Canc Ctr \& Res Inst, Dept Hlth Outcomes \& Behav, Tampa,
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FL 33612 USA.
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Hoover, Diana Stewart, Hoover Editing, Asheville, NC USA.
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Spears, Claire A., Georgia State Univ, Sch Publ Hlth, Div Hlth Promot \& Behav,
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Atlanta, GA USA.
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Nguyen, Nga, Univ Texas MD Anderson Canc Ctr, Dept Biostat, Houston, TX USA.
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Pineiro, Barbara, Univ Autonoma Barcelona, Ctr Estudis Demograf, Catalonia 08193,
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Spain.
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McNeill, Lorna H., Univ Texas MD Anderson Canc Ctr, Dept Hlth Dispar Res, Houston,
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TX USA.
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Wetter, David W., Univ Utah, Huntsman Canc Inst, Ctr Hlth Outcomes \& Populat Equ,
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Dept Populat Hlth Sci, Salt Lake City, UT USA.'
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author: Shorey Fennell, Bethany and Cottrell-Daniels, Cherell and Hoover, Diana Stewart
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and Spears, Claire A. and Nguyen, Nga and Pineiro, Barbara and McNeill, Lorna H.
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and Wetter, David W. and Vidrine, Damon J. and Vidrine I, Jennifer
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author-email: Bethany.ShoreyFennell@moffitt.org
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author_list:
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- family: Shorey Fennell
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given: Bethany
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- family: Cottrell-Daniels
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given: Cherell
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- family: Hoover
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given: Diana Stewart
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- family: Spears
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given: Claire A.
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- family: Nguyen
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given: Nga
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- family: Pineiro
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given: Barbara
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- family: McNeill
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given: Lorna H.
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- family: Wetter
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given: David W.
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- family: Vidrine
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given: Damon J.
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- family: Vidrine I
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given: Jennifer
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da: '2023-09-28'
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doi: 10.1093/tbm/ibad007
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earlyaccessdate: MAR 2023
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eissn: 1613-9860
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files: []
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issn: 1869-6716
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journal: TRANSLATIONAL BEHAVIORAL MEDICINE
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keywords: 'Implementation; Qualitative; Smoking cessation; Quitline; Latinos;
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Latinas; low-SES'
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keywords-plus: 'SMOKING-CESSATION; CIGARETTE-SMOKING; UNITED-STATES; PRIMARY-CARE;
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TOBACCO; INTERVENTION; SMOKERS; IMPACT; DISPARITIES; QUITLINES'
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language: English
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month: AUG 11
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number: '8'
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number-of-cited-references: '56'
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orcid-numbers: Shorey Fennell, Bethany/0000-0003-2188-6544
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pages: 551-560
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papis_id: 2c39f272764b307cfa51e9640e92a9f1
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ref: Shoreyfennell2023implementationaskadv
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times-cited: '0'
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title: 'The implementation of ask-advise-connect in a federally qualified health center:
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a mixed methods evaluation using the re-aim framework'
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type: Article
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unique-id: WOS:000961071600001
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usage-count-last-180-days: '3'
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usage-count-since-2013: '3'
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volume: '13'
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web-of-science-categories: Public, Environmental \& Occupational Health
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year: '2023'
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